53-year-old female patient with upper abdominal complaints for 8 months, icterus for 8 weeks, weight loss (6 kg) in the last 4 weeks => presentation to the emergency room.
Sonography reveals large atonic gallbladder, intra- and extrahepatic obstructive cholestasis due to a large pancreatic head tumor (locally irresectable). Sonographically double-duct sign. Endoscopic insertion of a covered metal stent (10mm/80mm) into the bile duct, sonographically well visualizable.